Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.
Universidad de Alcalá, Alcalá de Henares, Spain.
Front Public Health. 2023 Jun 26;11:1136988. doi: 10.3389/fpubh.2023.1136988. eCollection 2023.
Missed opportunities for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing remain high. We aimed to ascertain the knowledge of screening guidelines and attitudes of non-infectious disease (ID) hospital physicians and assess the impact of a 1-h session on screening rates and diagnoses.
This interventional study consisted of a 1-h training session on HIV and HCV epidemiology and testing guidelines for non-ID physicians. Pre-and post-session questionnaires compared the knowledge of the guidelines and attitudes toward screening before and after the session. Rates of screening and diagnoses were compared in three 6 months periods: before, immediately after, and 24 months ±4 after the session.
A total of 345 physicians from 31 departments participated in these sessions. Before the session, 19.9% (28% medical, 8% surgical) and 17.9% (30% medical, 2.7% surgical) were aware of HIV and HCV testing guidelines, respectively. The willingness to routinely test increased from 5.6 to 22%, whereas not ordering tests decreased from 34.1 to 2.4%. HIV screening rates significantly increased by 20% after the session (7.7 vs. 9.3 tests per 103 patients; < 0.001), and the effect persisted until the long-term period. The HIV diagnosis rate increased globally (3.6 vs. 5.2 HIV diagnoses per 105 patients; = 0.157), mainly because of medical services (4.7 vs. 7.7 per 105 patients; = 0.082). The HCV screening rate increased significantly immediately and in the long term only in medical services (15.7 and 13.6%, respectively). The new active HCV infection rates increased immediately and declined steeply thereafter.
A short session for non-ID physicians can improve HIV/HCV screening, increase diagnosis, and contribute to disease elimination.
人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）检测的错失机会仍然很高。我们旨在确定非传染病（ID）医院医生对筛查指南的了解程度和态度，并评估 1 小时会议对筛查率和诊断的影响。
这项干预研究包括为非 ID 医生进行 HIV 和 HCV 流行病学和检测指南的 1 小时培训课程。在课程前后的问卷比较了指南的知识和在课程前后对筛查的态度。在三个 6 个月的时间段内比较了筛查率和诊断率：课程之前、立即之后和课程之后 24 个月±4 个月。
共有 31 个科室的 345 名医生参加了这些课程。在课程之前，分别有 19.9%（28%为内科医生，8%为外科医生）和 17.9%（30%为内科医生，2.7%为外科医生）了解 HIV 和 HCV 检测指南。愿意常规检测的意愿从 5.6%增加到 22%，而不进行检测的意愿从 34.1%下降到 2.4%。课程之后 HIV 筛查率显著增加了 20%（每 103 名患者进行 7.7 次与 9.3 次检测；<0.001），并且该效果一直持续到长期。全球范围内 HIV 诊断率总体增加（每 105 名患者增加 3.6 次与 5.2 次 HIV 诊断；=0.157），主要是因为医疗服务（每 105 名患者增加 4.7 次与 7.7 次 HIV 诊断；=0.082）。仅在医疗服务中，HCV 筛查率在立即和长期都显著增加（分别为 15.7%和 13.6%）。新的丙型肝炎病毒活跃感染率立即增加，并在此后急剧下降。
为非 ID 医生举办的简短课程可以提高 HIV/HCV 筛查率，增加诊断，并有助于消除疾病。
